9/30/2016

Appointment Reciept

Ministry of External Affairs Government of India
Online Appointment Receipt
Applicant Details:
Paym ent Details #
Application Reference No.
16-0011444448
(ARN)

Total Fee (Rs.)

1500.00

Paid Fee (Rs.)

1500.00

Date and Time

28/09/2016 04:22 PM

Transaction Id

CP59406783

Service Type

FRESH

Type of Application

NORMAL

Given Name

JIGISHA ARPAN

Surname

PATEL

Appointm ent Details:

Gender

FEMALE

Father's Name

YOGESHBHAI PATEL

Passport Seva
Kendra Address

Mother's Name

BINABEN YOGESH PATEL

Spouse's Name

ARPANKUMAR PATEL

SURAT,
PASSPORT SEVA KENDRA,1ST FLOOR,UNION
TRADE CENTRE,BESIDES APPLE
HOSPITAL,UDHANA DARWAJA,SURAT-395007

Date of Birth

07/09/1995

100008837999316

Place of Birth

SURAT,SURAT CITY,GUJARAT

Marital Status

MARRIED

Employment Type

HOME MAKER

Appointment Id
Appointment
Date and Time
Reporting Date
and Time

03/10/2016 & 03:00 PM

03/10/2016 & 02:45 PM

Application Submitted Date 30/09/2016

Present Residential
Address

A 05 SHANTINIKETAN SOCIETY UTRAN

SURAT, SURAT, SURAT CITY, 394107,
GUJARAT, INDIA

Applicants References Details:

First Reference

ANUJ PATEL 40 ROOPSAGAR SOCIETY

A K ROAD SURAT, 9173408416

Second Reference

YOGESHKUMAR PATEL A 11
SHANTINIKETAN SOCIETY UTRAN
SURAT, 9726363016

Batch

24

Sequence No. 17

Please Read Carefully:

Please reach Passport Seva Kendra (PSK) at 02:45 PM as mentioned above and carry the printed copy of this appointment receipt.
Check Document Adv isor on website 'w w w .passportindia.gov .in' to know the documents required at PSK.Carry original documents and their
self attested photocopies. Final decision with regard to documents required is at the discretion of RPO staff at PSK.
In case of minor applicants (below 4 years of age), carry the recent passport size photograph (4.5 X 3.5 cm) with white background.
Only applicant is allowed inside the PSK. However, in case of exceptions such as Senior Citizen / Physically Challenged / Illiterate / Minor
applicants, one person from the family may be allowed to accompany inside PSK.
At PSK, a paper token will be issued to you after checking of documents.Your application will be processed at Counter A followed by counters
B and C. At all stages, please be alert and watch the token display screens to know the counter at which your application will be processed.
Please collect acknowledgement slip from the Exit counter before leaving PSK. Also,you are requested to fill the feedback form at the exit
counter.
You have not opted for 'Passport Seva SMS Services'. To enrol, please go to 'Enrol for SMS Services (Optional)' link available at 'Applicant
Home' Page of the website.
Balance fee (if applicable) after editing the submitted form will be payable in cash at the Passport Seva Kendra.
Help us to serv e you better.
# Details as per the Payment Date. Payment once made for av ailing passport serv ices w ill not be refunded.

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The following table lists Applicant Categories along with the Documents to be Submitted. The Document No. mentioned in
Documents to be Submitted column is the reference given to the document mentioned in List of Documents table.

Applicant Categories

Documents to be Submitted

Ordinary Case (Citizen of India by birth)

1, 2, 3 (if the applicant is eligible f or Non ECR)

Citizen of India by Descent (Born to Indian parent(s) outside India)

(i) 1, 2, 3 (if the applicant is eligible f or Non ECR)

(ii) 4 or 5 or 6

Citizen of India by Registration/ Naturalization (Granted citizenship by MHA)

1, 2, 3 (if the applicant is eligible f or Non ECR), 7

Applicants repatriated f rom abroad at Gov ernment cost

1, 2, 3 (if the applicant is eligible f or Non ECR), 5 (if av ailable), 8, 9

Applicants deported to India/ Emergency Certif icate cases

1, 2, 3 (if the applicant is eligible f or Non ECR), 5 (if av ailable), 8 (if any ), 9

Gov ernment/ Public Sector/ Statutory body employ ees

(i) 1, 2
(ii) 21 (if No Police Verif ication is required) or 20 (if Post Police Verif ication is
required) or 27 (if Pre Police Verif ication is required).

Dependent f amily members of Gov ernment/ Public Sector/ Statutory body

employ ees (For J&K children in age group 10-15 y ears are cov ered. For rest of
India children in age group 18-21 are cov ered)

1, 2, 3 (if the applicant is eligible f or Non ECR), 21 (of dependent) and 24 if No

Police Verif ication is required

Retired gov ernment of f icials

1, 2, 10 (if Post Police Verif ication is required)

Applicants hav ing Diplomatic/ Of f icial Passport and apply ing f or ordinary
Passport while in serv ice

(i) 1, 2 , 11 (12 if surrender certif icate is not available)

(ii) 21 or 20 or 27 if applicant is Gov ernment/Public Sector/Statutory body
employ ee
Note: In case the applicant submits "12", "2" is not required

Dependent f amily members of Diplomatic/ Of f icial Passport holders who are not
gov ernment serv ants (For J&K Children in age group 10-15 y ears are cov ered)

1, 2, 3 (if the applicant is eligible f or Non ECR), 26

Owner, partners and directors of Companies which are members of CII, FICCI & (i) 1, 2
ASSOCHAM.
(ii) 24 and 25 if Post PV is required
Minor change in name

1 (in new name), 2 (in old name), 3 (if the applicant is eligible f or Non ECR Documents in old name are allowed ), 23

Major change in name

1 (in new name), 2 (in old name), 3 (if the applicant is eligible f or Non ECR Documents in old name are allowed ), 13, 23

Change/ Addition in surname due to marriage

(i) 1, 2, 3 (if the applicant is eligible f or Non ECR)

(ii) 14 or 22

Change in name in case of Gov ernment/ Public Sector/ Statutory body

employ ees

1, 2, 15, 16, 23

Nagaland Residents

1, 2, 3 (if the applicant is eligible f or Non ECR)

Note: Additional PV required f rom Guwahati through MHA.

Naga origins residing outside Nagaland

1, 2, 3 (if the applicant is eligible f or Non ECR)

Note: Additional PV required f rom Guwahati through MHA.

Jammu and Kashmir Residents

1, 2, 3 (if the applicant is eligible f or Non ECR)

Jammu and Kashmir Residents stay ing outside J&K f or more than f iv e y ears

1, 2, 3 (if the applicant is eligible f or Non ECR)

Students stay ing away f rom their parent's current residence

1, 2, 3 (if the applicant is eligible f or Non ECR), 17, 18

Senior Citizens (For J&K: Men - 65+ y ears, Women - 60+ y ears; For rest of India 1, 2, 3 (if the applicant is eligible f or Non ECR), 19 (if Post Police Verif ication is
65+ y ears)
required)

Document
No.

List of Documents
Proof of Present Address. For Proof of Address attach one of the f ollowing documents:
a. Water bill/ Telephone (landline or post paid mobile bill)/ Electricity bill
b. Photo passbook of running Bank Account (Scheduled Public Sector Banks, Scheduled Priv ate Sector Indian Banks and Regional Rural
Banks only )
c. Income Tax Assessment Order
d. Election Commission Photo ID card
e. Gas connection bill
f . Certif icate f rom Employ er of reputed and widely known companies on letter head (Only public limited companies can giv e address proof
on company letter head along with seal. Computerised print-outs shall not be entertained)
g. Spouse's passport copy (First and last page including f amily details), (prov ided the applicant's present address matches the address
mentioned in the spouse's passport)
h. Parent's passport copy , in case of minors (First and last page)
i. Aadhaar Letter/ Card
j. Registered Rent Agreement

1. Note:
1. Applicants are required to submit the proof of address of the present address only , irrespectiv e of the date f rom which he/she has been

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residing at the giv en address. Howev er, he/she is required to mention all the place of stay during prev ious one y ear in the Passport
application f orm.
2. Furnishing of Aadhaar card will expedite processing of passport applications.
3. Aadhaar letter/card or the e-Aadhaar (an electronically generated letter f rom the website of UIDAI), as the case may be, will be accepted
as Proof of Address (POA) and Proof of Photo-Identity (POI) f or av ailing passport related serv ices. Acceptance of Aadhaar as PoA
and PoI would be subject to successf ul v alidation with Aadhaar database.
4. Any of the remaining documents containing address out of sixteen documents listed under Tatkaal application, could also be accepted as
proof of residence if such documents hav e the same present residential address as giv en by the applicant in the Passport Application
Form.
Proof of Date of Birth. For Proof of Date of Birth attach one of the f ollowing documents:

2.

a. Birth certif icate issued by a Municipal Authority or any of f ice authorized to issue Birth and Death Certif icate by the Registrar of Births &
Deaths
b. School leav ing certif icate / Secondary School leav ing certif icate/ Certif icate of Recognized Boards f rom the school last attended by the
applicant or any other recognized educational institution
c. Af f idav it sworn bef ore a Magistrate/Notary stating date/place of birth as per the specimen in Annexure "A" by illiterate or semi-illiterate
applicants (Less than 5th class).
For applicants born on or af ter 26.01.89, only Birth Certif icate issued by the Municipal Authority or any of f ice authorized to issue Birth and Death
Certif icate by the Registrar of Births & Deaths is acceptable. The Birth Certif icate should ordinarily contain the name of child, name of f ather and
mother, date of birth, place of birth, sex, registration number and date of registration. If the Birth Certif icate doesn't contain the name of child, a
declaration on plain paper signed by parents, is required to be submitted specif y ing the name of the child.

3.

Documentary proof f or any one of the Non-ECR (prev iously ECNR) categories, Ref er Column 2.15 under Section-B of passport instruction
booklet

4. Birth Registration Certif icate issued by Embassy / High Commission/ Consulate of India
5.

Old Passport in original with self -attested photocopy of its f irst two and last two pages, including ECR/Non-ECR page (prev iously ECNR) and the
page of observ ation (if any ), made by Passport Issuing Authority and v alidity extension page, if any , in respect of short v alidity passport

6.

Passport of parents in original with self -attested photocopy of its f irst two and last two pages, including ECR/Non-ECR page (prev iously ECNR)
and the page of observ ation (if any ), made by Passport Issuing Authority and v alidity extension page, if any , in respect of short v alidity passport

7. Citizenship Certif icate issued by Ministry of Home Af f airs

8. Proof of ref und of repatriation /deportation cost (if any ) to Ministry of External Af f airs
9. Original Emergency Certif icate/Seizure Memo issued by Airport Immigration Authorities on applicant's arriv al in India
10. Pension Pay ment Order
11. Proof of surrender or cancellation of Diplomatic/of f icial Passport
12. Cancelled Passport (if surrender certif icate is not av ailable), with a letter explaining why surrender certif icate is not av ailable
13.

Paper clipping of two leading daily newspapers in original (one daily newspaper should be of the area of Applicant's Permanent Address and the
other at Current Address or nearby area)

14. An attested copy of marriage certif icate issued by Registrar of Marriage

15. Gazette Notif ication changing name in applicant's department
16. Fresh ID Certif icate in changed name
17. Student Identity Card issued by Gov ernment Recognized Educational Institutions, in respect of f ull time courses
18. Bonaf ide Letter f rom authorized signatory of college (On of f icial letter head of UGC recognized College)
19. Copy of child's (Age>18) Passport , who is stay ing abroad (with page hav ing parent's name)
20. No Objection Certif icate (NOC) (as per Annexure 'M')
21. "Identity Certif icate" in original as per Annexure "B"
22.

A joint af f idav it f rom husband and wif e along with a joint photograph, (Specimen at Annexure "D") When joint af f idav it is not possible the af f idav it
should indicate the reason f or it. If apply ing f or passport f or the f irst time, this af f idav it is required only if there is a change in the f irst name.

23. Deed poll/sworn af f idav it as per Annexure "E"

24. Standard Af f idav it as per Annexure "I"
25. Verif ication Certif icate as per Annexure "J"
26. Photocopy of Diplomatic/ Of f icial Passport
27. Prior Intimation Letter (PI) (as per Annexure 'N')

Note: The list of documents provided in the table above is indicative. The decision of APO/RPO shall be considered final.

Print Application Receipt

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